Individual
DR. JOHN L HOLCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1210 OKLAHOMA AVE, TRENTON, MO 64683-2559
(660) 359-2204
(660) 359-4804
Mailing address
PO BOX 339, TRENTON, MO 64683-0339
(660) 359-2204
(660) 359-4804
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2175
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06429017
BLUE CROSS BLUE SHIELD
MO
Enumeration date
07/29/2005
Last updated
03/11/2008
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